371例次腹膜透析相关性腹膜炎的预后分析  

Clinical outcome of 371 episodes of peritoneal dialysis related peritonitis

作　　者：唐碧雯 方炜[1] 严豪[1] 袁江姿[1] 张敏芳[1] 黄佳颖[1] 顾爱萍[1] 林爱武[1] 倪兆慧[1] 钱家麒[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肾脏科上海市腹膜透析研究中心,200127

出　　处：《中华肾脏病杂志》2013年第11期808-811,共4页Chinese Journal of Nephrology

基　　金：上海市科委资助项目（07QA14040,08dz1900500）

摘　　要：目的分析本中心腹膜透析（腹透）相关性腹膜炎患者治疗的转归与预后，为腹透相关性腹膜炎的防治提供依据。方法人选2004年1月1日至2010年12月31日在上海交通大学医学院附属仁济医院腹透中心接受腹透治疗并发生腹透相关性腹膜炎的所有患者，分析7年间腹透相关性腹膜炎患者的转归与预后。结果研究期间共有220例患者发生了371次腹膜炎，腹膜炎发生率为1次／54．4患者·月。其中285例次（76．8％）的腹膜炎治愈，17例次（4．6％）的腹膜炎导致患者拔管转临时血液透析（血透），46例次（12．4％）的腹膜炎引起患者拔管转永久血透治疗，21例次（5．7％）的腹膜炎导致患者死亡。难治性腹膜炎患者的超滤能力（4h-UF）较腹膜炎发生前明显减少（330比270ml，P=0．036），4hD／Per较腹膜炎发生略有前升高[（0．55＋0．08）比（0．58＋0．10），P=0．0861。结论腹透相关性腹膜炎是导致腹透技术失败及患者死亡的重要原因，难治性腹膜炎可损害患者腹膜功能。Objective To analyze the clinical outcome of PD related peritonitis in our center. Methods All patients who developed PD related peritonitis between January 2004 and December 2010 in Renji Hospital of Shanghai Jiao Tong University School of Medicine were included. Outcomes of PD related peritonitis were analyzed. Results A total of 220 patients developed 371 episodes of PD related peritonitis during the study period in our center, and the average peritonitis rate was one episode per every 54.4 patient-months. Among the 371 episodes of peritonitis, 285 （76.8%） episodes had been cured, 17 （4.6%） episodes had needed temporary hemodialysis （HD）, 46 （12.4%） episodes had led to switch to permanent HD and 21 （5.7%） episodes had caused death. After refractory peritonitis, there was a significant reduction of 4 h uhrafiltration （330 vs 270 ml, P = 0.036） and an increase tendency of 4h D/Per （0.55± 0.08 vs 0.58± 0.10, P = 0.086）. Conclusions Peritoneal dialysis related peritonitis is an important contributor to technique failure and death in Chinese PD patients. Refractory peritonitis might injure peritoneal membrane function.

关 键 词：腹膜透析 预后 腹膜功能 腹膜透析相关性腹膜炎 

分 类 号：R459.5[医药卫生—治疗学]